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Without further state action, the rate of insured Californians could decrease and leave more than 4 million nonelderly Californians without health insurance by 2023, according to a study published Nov. 27 by the UC Berkeley Center for Labor Research and Education.

According to the study, 10.4 percent of Californians younger than 65 were uninsured in 2016 in spite of the Affordable Care Act, or ACA. The report estimated that between 150,000 and 450,000 more Californians will be uninsured in 2020, increasing to between 490,000 and 790,000 more — or 12.9 percent total — by 2023.

“That number is at a historic low because California has done a good job in general implementing (the) Affordable Care Act, but it’s going to increase unless the state takes action,” said lead report author Miranda Dietz, who works as a UC Berkeley Labor Center research and policy associate. Dietz added that the “main reason” for the projected increase is because the “individual mandate penalty is going to (be) zeroed out starting in 2019.”

Currently, California’s Medicaid program, commonly known as Medi-Cal, covers about one in three Californians. In 2019, the Trump administration will reduce the ACA individual mandate penalty, a penalty fee for uninsured people, to zero; the study projects that this will cause lower individual market and Medi-Cal enrollment.

Dietz said the study looked at the number of uninsured California residents younger than 65. The report stated that undocumented Californians will make up the largest group of uninsured individuals, but some other Californians qualified for health coverage such as Medi-Cal and employer coverage will also lack insurance. Uninsured Californians are also estimated in 2020 to be mostly Latinx and low-income Californians.

“There’s a number of different policy options that California has to try and cover folks who are still uninsured,” Dietz said. “They could expand Medicaid to cover low-income, undocumented Californians, they could provide subsidy from the state to help people afford coverage on the individual market, or they could consider a state-level individual mandate.”

According to Dietz, eligible undocumented students such as students protected under the Deferred Action for Childhood Arrivals program can get Medi-Cal if they meet the income requirements. If Medicaid were expanded further, however, it could provide students on campus and their families across California with “peace of mind that they have health insurance if something happens,” Dietz said.

Campus freshman Ricky Seo said that although state actions on health care do not directly affect him as an international student, many people on campus “need aid when it comes to health care.”

“There are many low-income or undocumented students in the UC system, or California in general,” Seo said. “If the state did anything to stop lower health coverage, it will probably impact a lot of families.”